Renal Flashcards
What is a GFR of 15-29?
CKD type 4
What is a GFR of 30-59?
CKD type 3
What is a GFR 60-89
CKD type 2
What is a GFR of 90 or above?
CKD type 1
What is GFR?
The plasma ultra-filtered across the glomerular capillaries in the nephrons in 1 minute.
What are the two labs you can draw for kidney function?
GFR and creatinine clearance
What is the best indicator of improving kidney function?
GFR
What is given to work on the pressure in the efferent arteriole to decrease the overall pressure in the kidneys?
ACE/ARB; it is given to diabetics.
What are the steps of filtration?
Corpuscle-glomerulus-bowmans capsule-proximal tubule-loop of henele-distal tubule- collected tubules.
What happens in the tubules?
Absorption and secretion
Where does filtration begin?
Corpuscle
How many nephrons are in each kidney?
1.2 million
What is considered the functional unit of the kidney?
Nephron
Where is urine formed?
Pelvis
Where is the loop of Henley located?
Medulla
Where are the glomerulus and tubules located?
Cortex
What is the purpose of the kidneys?
Excrete wastes, maintain BP, fluid and electrolyte and acid/base. Synthesize glucose and regulate hormones.
What are clinical manifestations of nephrotic syndrome?
Large amounts of proteinuria, hypoalbumenia, peri orbital and peripheral edema(3rd spacing) and prone to infection.
What is a distinguishing factor of nephrotic syndrome?
Excretion of 3.0 or more protein in urine.
What is happening to the glomerular permeability in nephrotic syndrome?
Increased; let’s fluid out; due to glomerular injury.
What is happening to the glomerular permeability in nephritic syndrome?
It is decreased
What happens when you have an obstruction from kidney stones?
Reduced perfusion from the obstruction activated the RAAS which causes constriction of peripheral arterioles.
What size of kidney stone can you pass?
5ml and under
What is the most common type of kidney stone?
Calcium oxalate
Where can you find pain with kidney stones?
CVA tenderness and pain referred to umbilicus.
What if you have positive leukocytes but negative nitrates in urine?
You know it’s bacteria because of positive leukocytes, so you would need to send it off for urine culture and sensitivity to see what type of bacteria is in the urine.
If you have positive leukocytes and positive nitrates in your urine what does that mean?
Leukocytes means bacteria in urine and nitrates mean gram negative bacteria; E Coli.
What is pylonephritis?
Reflux of urine, fever, flank pain, in lower urinary tract and ascends.
What is the cause of UTI for younger adults?
E. Coli
What is the cause of UTI in older adults?
Vaginitis
What are the signs of UTI in older adults?
Confusion, generalized abdominal pain
What are some clinical manifestations of polycystic kidney disease?
HTN, edema, decreased GFR, increase serum creatinine, decreased vitamin d and calcium, iron deficiency, clotting disorder, cardiac abnormalities.
What is polycystic kidney disease?
Inherited disorder, multiple cysts and they interfere with fluid absorption. Which creates a worsening kidney function and can result in kidney failure.
What causes glomerular disorders?
Immune mediated
What is glomerular disorder?
Disorder of the glomerulus where there is interference with the movement of water and small particles from the blood into filtrate. It prevents the blood and plasma proteins to leave circulation.
What is activated if only one kidney is affected and explain?
BP may increase r/t renin-angiotensin aldosterone system, esp if only 1 kidney is affected because it would activate the RAAS from the hypoperfusion in one kidney.
What happens to the urea in CKD? And what does it affect?
Urea increases and it affects clotting factors so you would see increase in bleeding.
What happens to vitamin d and calcium in CKD?
They decrease
What happens to erythropoietin in CKD?
Decreases, causing them to have a decrease in RBC and become anemic.
HTN and CKD or DM and CKD are what stage?
Stage 1
What are risk factors of CKD?
HTN and DM and have a higher risk if they have both with microalbunuria.
When do clinical manifestations occur in CKD?
Not until renal function declines to less than 25% of normal.
What is CKD?
Progressive loss of renal function associated with systemic disease, renal function loss and it is not reversible. GFR is less than 60 for 3 months.
What are the 3 stages of kidney Injury and give examples?
- Prerenal: renal hypoperfusion, no damage to kidney. Ex: dehydration and severe blood loss.
- Intrarenal: damage to tubules, tubular necrosis caused by ischemia(PE), contrast dye and meds
- Postrenal: obstruction to kidney, causes urine to back up. Tumors, stones,BPH
Is acute kidney reversible?
Yes and it has a sudden onset
What is the GFR directly related to?
RBF; blood flow to any organ is determined by the arteriovenous pressure differences across the vascular bed. If mean arterial pressure decreases or vascular resistance increases, RBF declines and urinary output decreases.
How much of cardiac output per minute do the kidneys receive?
20-25%
What is a GFR below 15?
CKD type 5 or failure
Nephritic syndrome is what kind of process and what are some of the clinical manifestations?
Infectious and they have RBC casts, hematuria, proteinuria, edema, HTN, impaired renal function.
What is the distinguishing characteristic of nephritic syndrome?
RBC casts
What is the cause of UTI in older adults?
Vaginitis
